Volunteer motivators for participating in HIV vaccine clinical trials in Nairobi, Kenya

Abstract

Background1.5 million Kenyans are living with HIV/AIDS as per 2015 estimates. Though there is a notable decline in new HIV infections, continued effort is still needed to develop an efficacious, accessible and affordable HIV vaccine. HIV vaccine clinical trials bear risks, hence a need to understand volunteer motivators for enrolment, retention and follow-up. Understanding the factors that motivate volunteers to participate in a clinical trial can help to strategize, refine targeting and thus increase enrolment of volunteers in future HIV vaccine clinical trials. The health belief model classifies motivators into social benefits such as ‘advancing research’ and collaboration with science, and personal benefits such as health benefits and financial interests.MethodA thematic analysis was carried out on data obtained from four HIV clinical trials conducted at KAVI-Institute of Clinical Research in Nairobi Kenya from 2009 to 2015. Responses were obtained from a Questionnaire administered to the volunteers during their screening visit at the research site.ResultsOf the 281 healthy, HIV-uninfected volunteers participating in this study; 38% were motivated by personal benefits including, 31% motivated by health benefits and 7% motivated by possible financial gains. In addition, 62% of the volunteers were motivated by social benefits with 20% of who were seeking to help their family/society/world while 42% were interested in advancing research.ConclusionThe majority of volunteers in the HIV vaccine trials at our site were motivated by social benefits, suggesting that altruism can be a major contributor to participation in HIV vaccine studies. Personal benefits were a secondary motivator for the volunteers. The motivators to volunteer in HIV clinical trials were similar across ages, education level and gender. Education on what is needed (including volunteer participation) to develop an efficacious vaccine could be the key to greater volunteer motivation to participate in HIV vaccine clinical trials.

Young at risk-people in Maputo City, Mozambique, present a high willingness to participate in HIV trials: Results from an HIV vaccine preparedness cohort study

“…Altruism was the most frequently reported positive social motivator for WTP in our study, and much of the same results were reported in other studies [32,35,36], suggesting that study participation may be seen by participants as their contribution to the fight against HIV. Important to highlight, was the increase in the proportion of negative social motives.…”

Willingness to participate in COVID-19 vaccine trials; a survey among a population of healthcare workers in Uganda

“…High education levels have been found to be associated with decreased willingness to participate in vaccine research elsewhere [ 37 ]. Participants with high levels of education are less likely to be motivated by non-altruistic reasons [ 38 ], a factor that may contribute to the relatively high level of unwillingness to participate in this sub-population. A high level of education may also be associated with having more knowledge about clinical trials.…”

A Qualitative Study on Experiences of HIV Vaccine Trial Participants in a Phase I/II Double Blinded, Randomized Placebo Controlled Clinical Trial in Tanzania: Lessons for COVID-19 Vaccine Testing

“…We also learnt that participants join the study for exterior motives such as to bene t humanity or in the words of the participants, to be part of the world's efforts to ght the HIV epidemic and protect future generations. A similar study in Kenya found that one-fth of their participants were motivated by the need to nd a vaccine for future generations (31). It is commendable that participants join trials for the bene t of others and not themselves.…”

“…While on average it takes at 10.7 years to develop a vaccine from preclinical phase to market registration, it is now decades before a vaccine is found for HIV pandemic (4). Previous trials such as one conducted in Thailand which found 31.2% e cacy brought with them promises for an effective vaccine although more work is still needed (5). While there are challenges in nding a vaccine, research has documented social implications and willingness to participate in HIV vaccine trials including knowledge about vaccine, hesitance, fear of side effects, perceived risks and bene ts of participation, was social factors have often been mentioned as key socio-challenges in the development of vaccines (6)(7)(8).…”